Provider First Line Business Practice Location Address:
3551 N BROAD ST
Provider Second Line Business Practice Location Address:
SHRINERS HOSPITAL FOR CHILDREN
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19140-4160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-430-4022
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2008